Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016

Amer N. Kadri, Bryan Wilner, Adrian V. Hernandez, Georges Nakhoul, Johnny Chahine, Brian Griffin, Gosta Pettersson, Richard Grimm, Jose Navia, Steven Gordon, Samir R. Kapadia, Serge C. Harb

Resultado de la investigación: Contribución a una revistaArtículoInvestigaciónrevisión exhaustiva

Resumen

Background: There has been an increase in the prevalence of drug abuse (DA) in the national opioid epidemic. With increasing DA, there is an increased risk of infective endocarditis (IE). There are limited recent data evaluating national trends on the incidence and geographical distribution of DA‐IE. We aim to investigate those numbers as well as the determinants of outcome in this patient population. Methods and Results: Hospitalized patients with a primary or secondary diagnosis of IE based on the International Classification of Diseases, Ninth and Tenth Revisions (ICD‐9, ICD‐10) were included. We described the national and geographical trends in DA‐IE. We also compared DA‐IE patients’ characteristics and outcomes to those with IE, but without associated drug abuse (non‐DA‐IE) using Poisson regression models. Incidence of DA‐IE has nearly doubled between 2002 and 2016 All US regions were affected, and the Midwest had the highest increase in DA‐IE hospitalizations (annual percent change=4.9%). Patients with DA‐IE were younger, more commonly white males, poorer, had fewer comorbidities, and were more likely to have human immunodeficiency virus, hepatitis C, concomitant alcohol abuse, and liver disease. Their length of stay was longer (9 versus 7 days; P<0.001) and were more likely to undergo cardiac surgery (7.8% versus 6.2%; P<0.001), but their inpatient mortality was lower (6.4% versus 9.1%; P<0.001). Conclusions: DA‐IE is rising at an alarming rate in the United States. All regions of the United States are affected, with the Midwest having the highest increase in rate. Young‐adult, poor, white males were the most affected.
Idioma originalInglés
Páginas (desde-hasta)e012969
PublicaciónJournal of the American Heart Association
Volumen8
N.º19
DOI
EstadoPublicada - 1 oct 2019

Huella dactilar

Endocarditis
Substance-Related Disorders
International Classification of Diseases
Incidence
Hepatitis C
Opioid Analgesics
Alcoholism
Thoracic Surgery
Comorbidity
Liver Diseases
Inpatients
Young Adult
Length of Stay
Hospitalization
HIV
Mortality

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Kadri, Amer N. ; Wilner, Bryan ; Hernandez, Adrian V. ; Nakhoul, Georges ; Chahine, Johnny ; Griffin, Brian ; Pettersson, Gosta ; Grimm, Richard ; Navia, Jose ; Gordon, Steven ; Kapadia, Samir R. ; Harb, Serge C. / Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016. En: Journal of the American Heart Association. 2019 ; Vol. 8, N.º 19. pp. e012969.
@article{72fd3bb3404d4eb2a472ca82de17f839,
title = "Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016",
abstract = "Background: There has been an increase in the prevalence of drug abuse (DA) in the national opioid epidemic. With increasing DA, there is an increased risk of infective endocarditis (IE). There are limited recent data evaluating national trends on the incidence and geographical distribution of DA‐IE. We aim to investigate those numbers as well as the determinants of outcome in this patient population. Methods and Results: Hospitalized patients with a primary or secondary diagnosis of IE based on the International Classification of Diseases, Ninth and Tenth Revisions (ICD‐9, ICD‐10) were included. We described the national and geographical trends in DA‐IE. We also compared DA‐IE patients’ characteristics and outcomes to those with IE, but without associated drug abuse (non‐DA‐IE) using Poisson regression models. Incidence of DA‐IE has nearly doubled between 2002 and 2016 All US regions were affected, and the Midwest had the highest increase in DA‐IE hospitalizations (annual percent change=4.9{\%}). Patients with DA‐IE were younger, more commonly white males, poorer, had fewer comorbidities, and were more likely to have human immunodeficiency virus, hepatitis C, concomitant alcohol abuse, and liver disease. Their length of stay was longer (9 versus 7 days; P<0.001) and were more likely to undergo cardiac surgery (7.8{\%} versus 6.2{\%}; P<0.001), but their inpatient mortality was lower (6.4{\%} versus 9.1{\%}; P<0.001). Conclusions: DA‐IE is rising at an alarming rate in the United States. All regions of the United States are affected, with the Midwest having the highest increase in rate. Young‐adult, poor, white males were the most affected.",
keywords = "drug abuse, epidemiology, infective endarteritis, morbidity/mortality",
author = "Kadri, {Amer N.} and Bryan Wilner and Hernandez, {Adrian V.} and Georges Nakhoul and Johnny Chahine and Brian Griffin and Gosta Pettersson and Richard Grimm and Jose Navia and Steven Gordon and Kapadia, {Samir R.} and Harb, {Serge C.}",
year = "2019",
month = "10",
day = "1",
doi = "10.1161/JAHA.119.012969",
language = "Ingl{\'e}s",
volume = "8",
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Kadri, AN, Wilner, B, Hernandez, AV, Nakhoul, G, Chahine, J, Griffin, B, Pettersson, G, Grimm, R, Navia, J, Gordon, S, Kapadia, SR & Harb, SC 2019, 'Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016', Journal of the American Heart Association, vol. 8, n.º 19, pp. e012969. https://doi.org/10.1161/JAHA.119.012969

Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016. / Kadri, Amer N.; Wilner, Bryan; Hernandez, Adrian V.; Nakhoul, Georges; Chahine, Johnny; Griffin, Brian; Pettersson, Gosta; Grimm, Richard; Navia, Jose; Gordon, Steven; Kapadia, Samir R.; Harb, Serge C.

En: Journal of the American Heart Association, Vol. 8, N.º 19, 01.10.2019, p. e012969.

Resultado de la investigación: Contribución a una revistaArtículoInvestigaciónrevisión exhaustiva

TY - JOUR

T1 - Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016

AU - Kadri, Amer N.

AU - Wilner, Bryan

AU - Hernandez, Adrian V.

AU - Nakhoul, Georges

AU - Chahine, Johnny

AU - Griffin, Brian

AU - Pettersson, Gosta

AU - Grimm, Richard

AU - Navia, Jose

AU - Gordon, Steven

AU - Kapadia, Samir R.

AU - Harb, Serge C.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: There has been an increase in the prevalence of drug abuse (DA) in the national opioid epidemic. With increasing DA, there is an increased risk of infective endocarditis (IE). There are limited recent data evaluating national trends on the incidence and geographical distribution of DA‐IE. We aim to investigate those numbers as well as the determinants of outcome in this patient population. Methods and Results: Hospitalized patients with a primary or secondary diagnosis of IE based on the International Classification of Diseases, Ninth and Tenth Revisions (ICD‐9, ICD‐10) were included. We described the national and geographical trends in DA‐IE. We also compared DA‐IE patients’ characteristics and outcomes to those with IE, but without associated drug abuse (non‐DA‐IE) using Poisson regression models. Incidence of DA‐IE has nearly doubled between 2002 and 2016 All US regions were affected, and the Midwest had the highest increase in DA‐IE hospitalizations (annual percent change=4.9%). Patients with DA‐IE were younger, more commonly white males, poorer, had fewer comorbidities, and were more likely to have human immunodeficiency virus, hepatitis C, concomitant alcohol abuse, and liver disease. Their length of stay was longer (9 versus 7 days; P<0.001) and were more likely to undergo cardiac surgery (7.8% versus 6.2%; P<0.001), but their inpatient mortality was lower (6.4% versus 9.1%; P<0.001). Conclusions: DA‐IE is rising at an alarming rate in the United States. All regions of the United States are affected, with the Midwest having the highest increase in rate. Young‐adult, poor, white males were the most affected.

AB - Background: There has been an increase in the prevalence of drug abuse (DA) in the national opioid epidemic. With increasing DA, there is an increased risk of infective endocarditis (IE). There are limited recent data evaluating national trends on the incidence and geographical distribution of DA‐IE. We aim to investigate those numbers as well as the determinants of outcome in this patient population. Methods and Results: Hospitalized patients with a primary or secondary diagnosis of IE based on the International Classification of Diseases, Ninth and Tenth Revisions (ICD‐9, ICD‐10) were included. We described the national and geographical trends in DA‐IE. We also compared DA‐IE patients’ characteristics and outcomes to those with IE, but without associated drug abuse (non‐DA‐IE) using Poisson regression models. Incidence of DA‐IE has nearly doubled between 2002 and 2016 All US regions were affected, and the Midwest had the highest increase in DA‐IE hospitalizations (annual percent change=4.9%). Patients with DA‐IE were younger, more commonly white males, poorer, had fewer comorbidities, and were more likely to have human immunodeficiency virus, hepatitis C, concomitant alcohol abuse, and liver disease. Their length of stay was longer (9 versus 7 days; P<0.001) and were more likely to undergo cardiac surgery (7.8% versus 6.2%; P<0.001), but their inpatient mortality was lower (6.4% versus 9.1%; P<0.001). Conclusions: DA‐IE is rising at an alarming rate in the United States. All regions of the United States are affected, with the Midwest having the highest increase in rate. Young‐adult, poor, white males were the most affected.

KW - drug abuse

KW - epidemiology

KW - infective endarteritis

KW - morbidity/mortality

UR - http://www.scopus.com/inward/record.url?scp=85072294735&partnerID=8YFLogxK

U2 - 10.1161/JAHA.119.012969

DO - 10.1161/JAHA.119.012969

M3 - Artículo

VL - 8

SP - e012969

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 19

ER -